Incidence of venous thromboembolic events in enhanced recovery after surgery for colon cancer: a retrospective, population-based cohort study.

Incidence of venous thromboembolic events in enhanced recovery after surgery for colon cancer: a retrospective, population-based cohort study.

Colorectal Dis. 2017 Nov;19(11):O393-O401.

What is already known:

VTE prophylaxis is an important but an often overlooked element of ERAS programmes. In the past VTE has a high morbidity and mortality, and most National guidelines have used old pre-ERAS evidence to base their recommendations. But now with ERAS programmes improving early mobilisation how has this affected the rate of symptomatic VTE, and in particular with only short-term VTE prophylaxis?

What this paper adds:

This Danish group conducted the first population-based cohort study to investigate the effect of in hospital only thromboprophylaxis within a colorectal ERAS programme. The risk of symptomatic venous thromboembolic events was found to be very low – only 0.2%. Raising the question of how beneficial is prolonged VTE prophylaxis for patients undergoing colorectal surgery within an ERAS programme. Randomised trials are warranted and national guidelines recommending prolonged thromboprophylaxis should be reconsidered.

Chris Jones, Guildford. @chrisnjones